How to help someone with BPD: 7 tips

Personality disorders conceal a number of peculiarities that can contribute to the emergence of conflicts in social relations, being Borderline Personality Disorder (BPD) one of the most commonly associated with this.

Due to daily frictions (some of which are significant), it is common for interest how to help someone with BPD, Pursue the goal of relieving own discomfort or that of the affected family member / friend.

In this article, we will study the specific characteristics of this alteration in the very structure of the personality, as this knowledge is essential to understand how a person with BPD feels and acts.

    Borderline Personality Disorder (BPD)

    TLP is a clinical entity that is part of the B group of personality disorders; alongside the anti-social, the histrionic and the narcissistic. Like the rest of those mentioned on the list, its core revolves around the difficulty of regulating emotions and behaviors. People who suffer from it often feel overwhelmed by their emotional life, which leads to noticeable instability in relationships with others and with themselves (their inner experience).

    These are people who suffer from difficulty controlling their impulses, which leads them to commit reckless acts that they may come to regret, feel guilty and ashamed of. They also often think that other people don’t really care about their lives and that they might abandon the relationship between them, a belief that ends up precipitating desperate acts to regain the affection and companionship they fear. to lose.

    The mechanisms by which they evaluate others are conditioned, like their own emotional experience, by instability and unpredictability. They tend to resort to extremes of idealization and devaluation, Ignoring the varied spectrum of shades of gray that may exist between them. Because of this, they often react with intense anger, turning into an emotional response that sometimes lasts for days.

    The instability that characterizes their judgments of others also extends to how they perceive themselves, revealing a constant fluctuation in self-image and identity. All of this can be accentuated when, in addition, dissociative symptoms such as depersonalization (a feeling of inner emptiness that results in a keen sense of being an automaton or some kind of empty shell) contribute to the same scenario.

    In addition to the above, which alludes to a profound experience of suffering, people with the disorder tend to frequently resort to threats or coercion in a disproportionate attempt to gain control of external circumstances that cause them to suffer. pain. The content of these threats may involve the production of self-harm or the resurgence of a pattern of harmful behavior in which they had been previously involved (substance use, unsafe sex, etc.).

    All of these circumstances, as well as others such as self-harm or verbal aggression (insults, provocations, sarcasm, etc.), foster a context of extreme relational tension. While today, there are empirically validated treatments to solve this mental health problem (such as Linehan’s Dialectical Behavior Therapy), which must also favor other approaches. it is essential that close circles learn how to help someone with BPD.

    Why is this happening?

    Many studies have been carried out to determine the causes of this personality disorder, although we currently only know the risk factors that contribute to its occurrence in a given individual. Most of them consider circumstances that unfolded during the childhood years, since it is during this period that they begin to shape the foundations on which its full clinical expression will be based (in adulthood ).

    One of the most important risk factors is the presence of psychopathology in the parents, Including mood disorders and TLP itself. Additionally, lack of warmth and parental explicit rejection of children has always been associated with an increased risk of suffering and inconsistent care. Hostility and high negative emotional expressiveness (from parents to children) also have a role to consider.

    The experience of long-term traumatic situations, usually in the form of child abuse (physical, emotional, verbal and sexual), is one of the risk factors on which there is currently a greater consensus on the part of the community. scientist. These prolonged stressful situations can also be associated with the presence of dissociative symptoms typical of PTSD.

    Basic affection styles have also been studied by researchers, Standing out from the empirical evidence that insecurity inclinations (especially anxiety) are decisive contributors to the formation of the disorder in adolescence and adulthood. Finally, the basic dimensions of the personality structure; like neuroticism, impulsivity and experiential avoidance, may be part of the premorbid profile of people with BPD.

    How to help someone with BPD

    Here are some suggestions that can help you deal with the daily frictions of living with people who have this important mental health problem. Implementing all of this advice can be an effort from the start and does not replace the psychological or pharmacological treatment regimen. Its purpose is only to facilitate the most difficult times.

    1. Validate your emotional experience

    People with BPD often feel that they are not understood by others and that they are the recipient of constant criticism for the way they think or feel. It is important to remember that people with BPD can experience very intense and lasting emotions when they perceive that they are the subject of an offense.

    This is why it is important learn to validate the experience as it is told, by showing support and listening; in a context of acceptance, honesty and avoidance of judgment.

      2. Offer support

      When faced with a situation of emotional overflow, let the person with TLP record your availability to spend time listening to what you have to say.

      The use of yelling or other negative communication strategies (both verbal and non-verbal) can lead to the abrupt termination of a connection opportunity and the consequent increase in difficult conditions. The rupture of the channels of emotional expression results in a distancing of the two parts it may take to resolve.

      3. Communicate your needs and allow them to speak

      It tells the person that you understand how you are feeling, shifting attention to the emotional experience rather than emphasizing the supposed relevance of the situation that preceded it.

      If you find it difficult to connect with his speech, encourage him to continue exploring it for the explicit purpose of understanding it. Speak clearly about what you do not consider tolerable at this very moment, Such as slurs or disrespect, establishing a pattern of contact.

      4. Get involved in treatment guidelines

      Many of the treatment guidelines offered to patients with BPD directly involve the family. Be interested in what is happening in the context of the intervention, respecting the limits of confidentiality and avoiding attitudes of a paternalistic nature. Shows his commitment to the improvement project in which he is committed, Contribute to the changes that must necessarily be articulated in the daily life of the person suffering from this trouble.

      5. Shows an understanding of symptom onset

      Many people with BPD learn to deal with their own difficulties and lead absolutely normal lives. However, it is very likely that at times (periods of intense stress, occasional relationship conflicts, etc.) there will be an increase in symptoms.

      Shows understanding and communicates hope that the emotion he is experiencing will eventually resolve –, As has happened on other occasions in the past.

      6. Learn strategies to regulate your own emotions.

      It is undeniable that the Coexistence with a person with BPD can mean suffering for the whole family, because from a systemic point of view, the family is a mechanism in which all the gears are relevant for their optimal functioning.

      Learn specific techniques to control autonomous activation, Like diaphragmatic breathing or Jacobson’s progressive muscle relaxation (always guided by a specialist), can help make difficult times more bearable.

      7. Seek professional help

      If your situation with a family member generates a stressful (distracted) reaction in you, it is important that you can take a break and seek professional help.

      Long-term stress can lead to a decline in our coping mechanisms (Even physiological), leading to exhaustion which increases the risk of many mental health problems (such as major depression or various anxiety disorders, among others).

      What should we avoid

      There are a number of things we should avoid when trying to help someone with BPD. The first is to develop behavior of overprotective or excessive condescension, as well as to maintain the belief that with our actions we will be able to solve all their problems. An important part of the improvement is learning to regulate the conditions, and for this reason who suffers from TLP must assume their daily life with the maximum of autonomy.

      You should also make an effort to not personalizing the harsh words that the person with BPD may say during a moment of angerAs this one deals not only with the conflict the two of you are in, but also the very symptoms of your disorder.

      Bibliographical references:

      • Stepp, SD, Lazarus, SA and Byrd, AL (2016). A systematic review of risk factors potentially associated with borderline personality disorder: taking stock and moving forward. Personality Disorders, 7 (4), 316-323.
      • Pierre, MH (2019). Borderline Personality Disorder: Clinical Guidelines for Treatment. Psychodynamic psychiatry, 47 (1), 5-26.

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